title: Aldehyde dehydrogenase 1 expression is a predictor of poor prognosis in node-positive breast cancers: a long-term follow-up study.
abstract: OBJECTIVE
  Aldehyde dehydrogenase 1 (ALDH1) has been identified as a reliable marker of breast cancer stem cells. The aim was to determine the prognostic significance of ALDH1 expression in a long-term follow-up study.
  
  
  RESULTS
  Immunohistochemical analyses were performed on 257 invasive ductal carcinomas (IDCs), 109 matched lymph node metastases and 190 ductal carcinomas in situ (DCISs), using paraffin-embedded sections. ALDH1 expression was found in 26% of IDCs, and correlated with larger tumour size (P=0.007), high histological grade (P<0.001), HER2 overexpression (P<0.001) and negative hormone receptor status (P<0.001). ALDH1 expression was observed in 14% of DCISs but was not correlated with any clinicopathological parameter. The IDC patients were followed up for 7-190 months (median: 120 months), and groups with ALDH1 expression had shorter relapse-free survival (P=0.0013) and overall survival (OS) (P=0.0005) by log-rank test. By Cox's multivariate analysis, it had a weak effect on OS (P=0.047), and its most significant effect on OS was observed in node-positive groups (P=0.013). No significant differences in OS stratified by ALDH1 expression status in lymph node metastases were noted.
  
  
  CONCLUSIONS
  ALDH1 expression in primary cancer is an independent prognostic factor in node-positive breast cancer patients.
authors.affiliation: Department of Molecular and Cellular Pathology, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Yoshioka
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Umekita
authors.forename: Yasuyo
authors.initials: Y
authors.lastname: Ohi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Souda
authors.forename: Yoshiatsu
authors.initials: Y
authors.lastname: Sagara
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Sagara
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Sagara
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Rai
authors.forename: Akihide
authors.initials: A
authors.lastname: Tanimoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000080924:Aldehyde Dehydrogenase 1 Family; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000201:enzymology* / Q000401:mortality / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000201:enzymology* / Q000401:mortality / Q000473:pathology; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007527:Isoenzymes / Q000096:biosynthesis* / Q000378:metabolism; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D050697:Retinal Dehydrogenase / Q000096:biosynthesis* / Q000378:metabolism; D015996:Survival Rate; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D007527:Isoenzymes; D000080924:Aldehyde Dehydrogenase 1 Family; C510223:ALDH1A1 protein, human; D050697:Retinal Dehydrogenase